HPLC Study of Uremic Fluids Related to Optical Dialysis Adequacy Monitoring

Lauri, Kai; Tanner, Risto; Jerotskaja, Jana; Luman, Merike; Fridolin, Ivo

doi:10.1177/039139881003300205

Cited by 12 publications

(10 citation statements)

References 21 publications

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“…This has been confirmed also by earlier studies [11,12] . Moreover, HPLC studies have demonstrated that UA is an UV-absorbing solute in the studied wavelength range, and therefore influences the UV-signal substantially [13] . This explains why UA had the same wavelength maximum at both treatment modalities.…”

Section: Discussionmentioning

confidence: 95%

Optical Estimation of Beta 2 Microglobulin during Hemodiafiltration - Does It Work?

et al. 2015

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Background: Currently, urea reduction seems to be the most widely used dialysis dose parameter. The aim of this study was to investigate the possibility to monitor beta 2-microglobulin (β2-M) elimination by utilizing the ultraviolet (UV) absorbance of spent dialysate. Methods: Blood and spent dialysate were collected during two week's sessions in 8 patients, one week in hemodialysis (HD) and one in hemodiafiltration (HDF). Correlation analysis between UV-wavelengths and concentrations of solutes in spent dialysate was performed. The reduction ratio (RR) of concentrations in blood, dialysate and UV-absorbance were compared. Results: Differences between HD and HDF were discovered in wavelength correlation maxima for the solutes. Relative error in RR (%) was larger (p < 0.05) for β2-M than for the other solutes. The most reasonable explanation is that β2-M does not absorb UV-radiation; instead, the absorbance of surrogate substances is measured. Conclusion: A high correlation between UV-absorbance and β2-M can be achieved for HDF but not for HD. Still, UV-absorbance could perhaps be used in solely HDF mode for estimation of β2-M removal.

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Section: Discussionmentioning

confidence: 95%

Optical Estimation of Beta 2 Microglobulin during Hemodiafiltration - Does It Work?

et al. 2015

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“…The typical UV monitoring curve of elimination of small water-soluble uremic toxins by dialysis has been presented, and details of liquid chromatographic analysis of spent dialysate discussed elsewhere by our group in connection with assessment of online dialysis dose monitoring by UV absorbance [10, 12, 13]. The peak of UA is well separated from peaks of PAR and its metabolites on the chromatograms [12] and any possibility of analytical interference of PAR+ metabolites in HPLC estimation of UA content in spent dialysate seems not to be possible.…”

Section: Discussionmentioning

confidence: 99%

“…The dialysate flow was 500 mL/min and the blood flow varied from 245 to 350 mL/min depending on the patient but was kept stable during dialysis session. Spent dialysate was sampled hourly or more frequently and the content of main well-known uremic toxins in samples were analyzed using high performance liquid chromatography as described previously [12, 13]. Chromatograms at the wavelengths of 254 and 280 nm were monitored and quantitative calculations were made on the basis of the peak areas on the chromatograms at 280 nm for uric acid (UA) and at 254 nm for PAR and its metabolites (PAR+M).…”

Section: Methodsmentioning

confidence: 99%

Paracetamol Interference in Uric Acid Levels in Uremic Patients Revealed by Monitoring Spent Dialysate

et al. 2013

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The aim of this study was to assess removal dynamics of paracetamol (PAR), as an extraordinary chromophore in spent dialysate, upon the optical monitoring of dialysis of end-stage renal disease patients with inflammation complications. Seven dialysis sessions of different patients were followed to whom PAR was used as a pain reliever or antipyretic. Spent dialysate was sampled hourly and analyzed using HPLC with MS/MS and UV detection. Quantitative calculations were made on the basis of the peak areas on the chromatograms at 280 nm for uric acid (UA) and 254 nm for PAR and its metabolites (PAR-M). Peaks of UA, PAR, PAR-glucuronide, and PAR-sulphate were identified on the basis of specific mass spectra. Removal of PAR was found to be proportional to that of uric acid if intake of the drug by patient occurred half a day before dialysis. But disturbances of the UV-absorbance curves at 280 nm were observed related to rise of UA concentration in spent dialysate when PAR was taken by patients in the course of dialysis. The mechanism of such relation remains unknown. It was concluded that possible benefits and risks of treatment of uremic patients with paracetamol-containing drugs may need to be reassessed.

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“…This difference could be explained by specific removal characteristics for creatinine compared to the net removal of the UV-absorbing chromophores contributing to the optically measured signal in spent dialysate. Despite that the online UV-absorbance at 280 nm was closest to the removal of small water-soluble non-protein bound solutes like urea, creatinine and uric acid [ 16,17 ], the overall removal pattern is far more complex because each uremic solute has still a distinctive distribution volume in the body and removal rate during dialysis. This is expressed also by independent components in the models, including several wavelengths, proposed in this study.…”

Section: Discussionmentioning

confidence: 99%

Development of a method for optical monitoring of creatinine in the spent dialysate

Tomson

Uhlin²,

Holmar³

et al. 2011

Estonian J. Eng.

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The aim of the study was to develop a method suitable for the estimation of the amount of creatinine, removed during dialysis through UV-absorbance. Sixteen uremic patients, seven females and nine males, on chronic thrice-weekly hemodialysis were included in the study. Doublebeam spectrophotometer was used for the determination of UV-absorbance in the collected spent dialysate samples. Due to differences in independent variables, two multi-wavelength models (m1 and m2) were developed using stepwise regression, utilizing creatinine values from the laboratory as the dependent parameter. The coefficient of determination, R 2 was 0.8690 for the first and 0.9103 for the second model. The systematic error, estimated as BIAS, was zero for both models compared to the creatinine values from the laboratory. The standard errors were 10.06 µmol/l and 15.24 µmol/l for m1 and m2, respectively. The average reduction ratio (RR) from creatinine blood values was 59.8 ± 5.4% (N = 50), average RR from m1 was 63.7 ± 7.3% (N = 50) and average RR from m2 was 64.8 ± 6.4% (N = 48). In summary, the amount of creatinine removed as well as the reduction ratio of creatinine during dialysis can be estimated with UV-absorbance technique.

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HPLC Study of Uremic Fluids Related to Optical Dialysis Adequacy Monitoring

Abstract: The present study contributes new information on the removal of uremic retention solutes during hemodialysis and on the origin of the optical dialysis adequacy monitoring signal.

Cited by 12 publications

References 21 publications

Optical Estimation of Beta 2 Microglobulin during Hemodiafiltration - Does It Work?

Optical Estimation of Beta 2 Microglobulin during Hemodiafiltration - Does It Work?

Paracetamol Interference in Uric Acid Levels in Uremic Patients Revealed by Monitoring Spent Dialysate

Development of a method for optical monitoring of creatinine in the spent dialysate

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